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Foot Based Problems

Fractured Pedal Bone

Diagram of the foot

The pedal bone is the largest bone within the hoof capsule and is the same shape as the hoof. It can be fractured in the front foot by sudden trauma, such as sudden turning. In the hind foot it is most commonly injured when the horse has kicked out against the stable wall. If the fracture does not extend into the coffin joint (when surgery may be required) recuperation is generally successful. A bar shoe is applied to the foot to provide maximum support. After an initial month’s box rest, a gradually ascending walking out programme from the box is instigated. Recovery tends to be complete but it can take up to 6 months before the patient is back in full work.

Pedal Bone Osteitis

X-Rays are used to aid diagnosis

Pedal osteitis is usually the result of a sharp trauma to the sole of the foot, damaging the pedal bone lying immediately above the sole. It occurs most often as the result of standing on a sharp stone or a nail. If infection is introduced by the sharp object, then the pedal bone can also become infected (septic pedal osteitis). Treatment is by aggressive removal of infected tissue and/or damaged bone. This is then followed by remedial farriery to protect and support the damaged area to accelerate healing. While initially a very painful condition, horses with pedal osteitis usually make an excellent recovery provided they have the right care.

Coffin Joint Osteoarthritis

The coffin joint is the lowest joint in the horses’ limb and is consequently under much pressure. Osteoarthritis is a common finding in older horses, especially those that have had active athletic careers. It is also commonly found in heavier horses. Affected horses will present with a significant lameness. While surgical exploration of the joint is possible, most horses are usually treated with pain relief and remedial shoeing. On some occasions, de-nerving of the feet can be carried out- this is a surgical procedure performed under general anaesthesia. Recovery is generally incomplete and affected horses will usually come back to work at a lower level of athletic demand than before the lameness developed.

Collateral Ligament Injury of Coffin Joint

Horse sedated while the MRI is performed, reading the images to aid diagnosis

With the advent of Magnetic Resonance Imaging (MRI), injury of the collateral ligaments of the coffin joint is an increasingly diagnosed cause of lameness in the foot. The collateral ligaments can only be visualised with MRI.

Prior to this, many such affected horses were mistakenly diagnosed as having “navicular disease” as the collateral ligament can only be imaged by MRI. Injuries to the collateral ligaments of the coffin joint are most common in horses that have had imbalance problems in their feet. Treatment involves remedial shoeing and box rest allied to a gradually ascending walking out programme. A condition seen most commonly in show jumpers, although recovery tends to be slow it can be complete.

Deep Digital Flexor Tendon Injury

Unlike the SDF tendon, the DDF tendon is very rarely injured in the area of the cannon bone. However it is frequently injured within the foot at the point where it passes over the navicular bone. At this site the DDF tendon undergoes a sharp change in direction. Tears to the DDF tendon here can be very painful and difficult to treat. Most commonly such injuries are confirmed by MRI before remedial shoeing and a box rest/walking out programme is instigated. Prognosis for this condition is guarded with many horses failing to recover while others recover but then relapse when introduced to work. A surgical procedure has been developed where the damaged area of the tendon is cleaned of debris. To date, any benefits of performing the surgery as opposed to simply resting are not clear.